tbuckley/cabot-search huggingface dataset:
POS0855 EVOLUTION OF RHEUMATOID ARTHRITIS-ASSOCIATED INTERSTITIAL LUNG DISEASE IN PATIENTS TREATED WITH JAK INHIBITORS: A MULTICENTER RETROSPECTIVE STUDY
Authors: V. Venerito, A. Manfredi, A. Carletto, S. Gentileschi, F. Atzeni, S. Guiducci, M. Lavista, L. La Corte, E. Pedrollo, A. Scardapane, C. Tomassini, B. Frediani, C. Salvarani, F. Iannone, M. Sebastiani
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The treatment to adopt when (Interstitial Lung Disease)ILD is detected in Rheumatoid Arthritis (RA) patients has always been a matter of debate. The management and treatment of RA-ILD is challenging because there is still little information available on this topic, and the main literature comes from observational studies. No clinical trials have been dedicated to this topic, however its consideration is increasing in guidelines. There is relatively limited data on the use of JAKi in patients with RA-associated ILD. <h3>Objectives</h3> The aim of this multicenter retrospective study was to investigate the effectiveness and safety of the available JAKi in patients with RA-ILD. <h3>Methods</h3> We retrospectively analyzed patients with classified RA and RA-ILD undergoing JAKi in 6 Italian tertiary centres from April 2018 to June 2022. We included patients with at least 6 months of active therapy and one high-resolution chest tomography (HRCT) carried out within 3 months before the start of JAKi treatment. The HRCT was then compared to the most recent one carried out within 3 months before the last available follow-up appointment. We also kept track of the pulmonary function tests. <h3>Results</h3> We included 43 patients with RA-ILD, 23 males (53.48%) with median age (interquartile range, IQR) of 68.87 (61.46-75.78) treated with JAKi. Clinical and disease characteristics have been reported in Table 1. The median follow-up was 19.1 months (11.03–34.43). The forced vital capacity remained stable in 22/28 (78.57%) patients, improved in 3/28 (10.71%) and worsened in 3/28 (10.71%). The diffusing Capacity of Lung for Carbon Monoxide showed a similar trend, remaining stable in 18/25 (72%) patients, improving in 2/25 (8%) and worsening in 5/25 (20%). The HRCT remained stable in 37/43 (86.05) cases, worsened in 4/43 (9.30%) and improved in the last 2 (4.65%) (Figure 1). <h3>Conclusion</h3> This study seems to confirm that JAKi therapy might be a safe therapeutic option for patients with RA-ILD. <h3>References</h3> [1]Manfredi, A.; Cassone, G.; Luppi, F.; Atienza-Mateo, B.; Cavazza, A.; Sverzellati, N.; González-Gay, M.A.; Salvarani, C.; Sebastiani, M. Rheumatoid Arthritis Related Interstitial Lung Disease. <i>Expert Rev Clin Immunol</i> 2021, <i>17</i>, 485–497, doi:10.1080/1744666X.2021.1905524. [2]Holroyd, C.R.; Seth, R.; Bukhari, M.; Malaviya, A.; Holmes, C.; Curtis, E.; Chan, C.; Yusuf, M.A.; Litwic, A.; Smolen, S.; et al. The British Society for Rheumatology Biologic DMARD Safety Guidelines in Inflammatory Arthritis. <i>Rheumatology (Oxford</i>) 2019, <i>58</i>, e3–e42, doi:10.1093/rheumatology/key208. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0455 THE STATUS OF BREG CELLS AND BREG-RELATED CYTOKINES IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: J. Luo, Q. Y. Su, Q. Li, X. Zhang, S. Q. Yang, Y. R. Liu, H. Y. Gao, Q. Yu, P. F. He, X. Li, S. X. Zhang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatoid arthritis (RA) is the most common autoimmune arthritis worldwide, with a prevalence of around 1%. Regulatory B cells (Bregs) are unique subpopulations of B cells with immune-regulating properties. Interestingly, different subsets of Breg cells have distinct markers and phenotypes and participate in self-immune regulation in different ways. However, the level of Breg cells in RA remains debated. <h3>Objectives</h3> This study aimed to clarify the proportions of Breg cells with special controversial cellular markers in RA patients. <h3>Methods</h3> We explored the proportion of Breg cells in RA patients by searching literature through January 10, 2023, from PubMed, Web of Science, Embase, CNKI, and Wanfang Patent Database. Random effects model was used to pool data. Heterogeneity and risk of bias were examined with the I-squared index (I<sup>2</sup>) statistic. Inconsistency was evaluated using the I<sup>2</sup> and Egger tests to assess potential publication bias (STATA v.12.0). <h3>Results</h3> A total of 14 case-control studies involving 372 RA patients and 321 healthy controls (HCs) were included in this study. No significant difference in the proportions of Breg cells was evident between RA patients and HCs[SMD=-0.445, 95%CI (-1.258, 0.369), P=0.284] with no publication bias based on the Egger tests (t =-1.33, p=0.212) (Figure 1). Because of a significant statistical heterogeneity observed [I<sup>2</sup>=94.0%, p&lt;0.001], we conducted sub-analyses based on individual definitions of Breg cells. We found the proportions of CD19<sup>+</sup>TGFβ<sup>+</sup>, CD19<sup>+</sup>CD24<sup>hi</sup>CD38<sup>hi</sup> and CD19<sup>+</sup>CD24<sup>hi</sup>CD27<sup>+</sup> Breg cells was significantly decreased in RA [SMD=-0.895, 95%CI (-1.442, -0.347), P=0.001; SMD=-1.490, 95%CI (-2.827, -0.152), P=0.029; SMD=-0.917, 95%CI (-1.822, -0.013), P=0.047] (Figure 1). The level of CD19<sup>+</sup>CD5<sup>+</sup>GrB<sup>+</sup> was increased in RA compared to that of HCs [SMD=2.372, 95%CI (1.936, 2.809), P&lt;0.001]. <h3>Conclusion</h3> CD19<sup>+</sup>TGFβ<sup>+</sup>, CD19<sup>+</sup>CD24<sup>hi</sup>CD38<sup>hi</sup>, and CD19<sup>+</sup>CD24<sup>hi</sup>CD27<sup>+</sup> Breg cells were significantly decreased in RA patients, and CD19<sup>+</sup>CD5<sup>+</sup>GrB<sup>+</sup> Breg cells were increased in RA, suggesting that the abnormalities of Breg cells numbers and function are the critical causes in the development of RA. <h3>Acknowledgements</h3> This work was supported by the National Natural Science Foundation of China (No. 82001740). <h3>Disclosure of Interests</h3> None Declared.
POS0406 INCREASE OF CARTILAGE REGENERATION BY IFN-Γ IN CARTILAGE INJURY MOUSE MODEL
Authors: H. A. Kim, J. R. Kim
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Until now, there was no effective cure for cartilage injury and degeneration commonly occurring in joint injury and OA. The efficiency of cartilage regeneration in young people is generally considered higher than in the elderly. <h3>Objectives</h3> In this study we investigated candidate genes associated with cartilage regeneration in knee joints of young and adult mice using a full-thickness cartilage injury (FTCI) mouse model. <h3>Methods</h3> Young (3 week-old) and adult mice (9 week-old) were subjected to FTCI and cartilage was harvested at 3, 7, and 14 days after FTCI. Cartilage regeneration was evaluated with safranin O staining and immunohistochemistry. For discovery of novel genes associated with cartilage regeneration, RNA-seq analysis was performed. For differentiation into chondrocytes, ATDC5 cells were monolayer and 3D cultured in DMEM containing insulin-transferrin-selenium (ITS) for 7 and 14 days. Chondrocyte specific IFN- γ receptor 1 knock out mice were created to examine the influence of IFN signaling in cartilage repair. <h3>Results</h3> Cartilage regeneration significantly increased in damaged region of FTCI in young mice compared with that of adult mice at 7 and 14 days. Gene expression profiles of cartilage from young and adult mice of 3 day (damaged stage) and 14 day (repair stage) after FTCI were examined by RNA-seq analysis. A total of 1115 (448 up- and 667 down-regulated) and 2294 (726 up- and 1568 down-regulated) differentially expressed genes (DEGs) were identified in young mice compared with adult mice at 3 and 14 days after FTCI, respectively. Gene ontology (GO) analysis revealed that genes responsible for interferon gamma (IFN-γ) and innate immune response, and cell proliferation, cell-substrate adhesion, and wound response were significantly up-regulated in the young mice at 3 and 14 days after FTCI, respectively. In particular, our data using monolayer and micromass culture of ATDC5 cells showed that blockade of IFN-γ signal by small interference RNA (si-IFN-γ receptor) suppressed synthesis of anabolic factors, including ACAN and Col II, along with decreased chondrogenic differentiation of ATDC5 cells, whereas treatment with IFN-γ (20 ng/ml) up-regulated synthesis of anabolic factors and chondrogenic differentiation. Cartilage repair score after FTCI was significantly worse in chondrocyte specific IFN- γ receptor 1 knock out mice compared to WT. <h3>Conclusion</h3> IFN-γ signaling may play a critical role in the process of cartilage regeneration. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0557 COVID-19 OUTCOMES IN KOREAN PATIENTS WITH GOUT
Authors: M. J. Kim, B. Ryu, S. Yi, J. W. Park, Y. Jang, K. Shin
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Patients with autoimmune inflammatory rheumatic diseases are at higher risk for coronavirus disease (COVID)-19 hospitalization and worse clinical outcomes compared with the general population. However, data on the association between COVID-19 outcomes and gout, or gout-related medications are still lacking. <h3>Objectives</h3> We aimed to compare COVID-19 related clinical outcomes in gout vs. non-gout patients. <h3>Methods</h3> We conducted a retrospective cohort study using the electronic health record-based databases of Seoul National University hospital (SNUH) from January 2021 to April 2022 mapped to a common data model. Patients with gout and without gout were matched using a large-scale propensity score (PS) algorithm. The clinical outcomes of interest were COVID-19 infection, severe COVID-19 outcomes defined as the use of mechanical ventilation, tracheostomy or extracorporeal membrane oxygenation, and death within 30 days of COVID-19 diagnosis. The hazard ratio (HR) for gout vs. non-gout patients derived by Cox proportional hazard models were estimated utilizing a 1:5 PS-matched cohort. <h3>Results</h3> 2,683 patients with gout and 417,035 patients without gout were identified among the patients who visited SNUH. After 1:5 PS matching, 1,363 gout patients and 4,030 non-gout patients remained for the analysis. The risk of COVID-19 infection was not significantly different between patients with gout and those without gout (HR 1.07 [95% CI 0.59-1.84]). Within the first month after the COVID-19 diagnosis, there was also no significant difference in the risk of hospitalization (HR 0.57 [95% CI 0.03-3.90], severe COVID-19 outcomes (HR 2.90 [95% CI 0.54-13.71]), or death (HR 1.35 [95% CI 0.06-16.24]). <h3>Conclusion</h3> Patients with gout did not have an increased risk of COVID-19 infection or worse clinical outcomes. Updates of temporal trends of COVID-19 outcomes in gout patients are yet warranted as new SARS-CoV-2 variants emerge. <h3>References</h3> [1]Shin YH, et al. Autoimmune inflammatory rheumatic diseases and COVID-19 outcomes in South Korea: a nationwide cohort study. Lancet Rheumatol. 2021 Oct;3(10):e698-e706. [2]Topless RK, et al. Gout and the risk of COVID-19 diagnosis and death in the UK Biobank: a population-based study. Lancet Rheumatol. 2022 Apr;4(4):e274-e281. [3]Xie D, et al. Gout and Excess Risk of Severe SARS-CoV-2 Infection Among Vaccinated Individuals: A General Population Study. Arthritis Rheumatol.2023 Jan;75(1):122-132. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0592-HPR IDENTIFYING IMPORTANT CLINICAL FEATURES FOR PREDICTING REMISSION IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH BIOLOGICS USING MACHINE LEARNING MODEL
Authors: A. Alsaber, A. Al-Herz, B. Alawadhi, P. Setiya, K. Saleh, A. Al-Awadhi, W. Al-Kandari, E. Hasan, K. Mokaddem, A. Ghanem, Y. Bartella, M. Hussein, N. Alhadhood, Y. Ali, E. Nahar, A. Aldei, A. Alenizi, S.H.M. Hayat, F. Abutiban, H. Behbehani
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Biologic disease-modifying antirheumatic drugs (bDMARDs) offer promising results for rheumatoid arthritis (RA) patients in general, but a substantial percentage of patients do not respond to them. It is important to predict the response before the treatment so that unnecessary adversities for the patients and costs for the healthcare system can be avoided. We developed a model to predict remissions in patients treated with bDMARDs and to identify important clinical features associated with remission using several machine learning (ML) models system that works with readily-available demographic and clinical factors for prediction of response to DAS-28. <h3>Objectives</h3> In this study, we established a machine learning model using data from the Kuwait Registry for Rheumatic Diseases (KRRD) and show its application to identifying clinical variables predictive of remission in RA patients treated with biologics. <h3>Methods</h3> We gathered the follow-up data of 1,000 patients treated with bDMARDs (etanercept, adalimumab, golimumab, infliximab, abatacept, and tocilizumab) from KRRD. Patients were recruited from public hospitals in Kuwait between February 2013 to September 2022. Remission (DAS-28 less than 2.6) was predicted at 1-year follow-up using baseline clinical data obtained at the time of enrollment. Machine learning methods system (including: lasso, ridge, support vector machine, random forest, XGBoost, and Shapley additive explanation (SHAP)) were used for the predictions. <h3>Results</h3> The ranges for accuracy and area under the receiver operating characteristic of the newly developed machine learning model for predicting remission were 52.8–72.9% and 0.463–0.719, respectively. The Shapley plot in XAI showed that the impacts of the variables on predicting remission differed for each bDMARD. The most important features were age for adalimumab, rheumatoid factor for etanercept, erythrocyte sedimentation rate for infliximab and golimumab, disease duration for abatacept, and C-reactive protein for tocilizumab, with mean SHAP values of − 0.250, − 0.234, − 0.514, − 0.227, − 0.804, and 0.135, respectively. <h3>Conclusion</h3> Our proposed machine learning model system successfully identified clinical features that were predictive of remission in each of the bDMARDs. This approach may be useful for improving treatment outcomes by identifying clinical information related to remissions in patients with rheumatoid arthritis. <h3>Acknowledgements</h3> I would like to acknowledge Kuwait Registry for Rheumatic Diseases (KRRD), for providing us the needed data. <h3>Disclosure of Interests</h3> None Declared.
POS0389 THE PREVALENCE OF GLUCOCORTICOID PRESCRIPTIONS IN ICELAND OVER 17 YEARS AND ACTIVE OSTEOPOROSIS PREVENTION FOR LONG-TERM USERS
Authors: H. H. Bjornsdottir, O. Einarsson, G. Gröndal, B. Gudbjornsson
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Glucocorticoid steroids (GCS) are frequently prescribed, and side effects are well-known, such as corticosteroid-induced osteoporosis (CIOP). <h3>Objectives</h3> To estimate the nationwide trend in the prevalence of glucocorticoid prescription over 17 years and to elucidate the proportion of patients on long-term GCS therapy who receive active bone protective therapy. <h3>Methods</h3> This retrospective observational registry study extended over 17 years (2003-2020). Data were retrieved from the Icelandic Prescription Medicine Register (IPMR) on all delivered GCS (ACT: H02AB) for oral use. Long-term users were defined as those who annually received ≥90 defined daily doses of GCS. We defined an individual on active bone protective therapy if, within ±45 days of receiving a prescription for GCS, they also filled a prescription of a bone protective agent. <h3>Results</h3> Annually, 3.8% of the Icelandic population received oral GCS, from 3.3% in 2006 to 4.3% in 2017. There was a significant increase in prescriptions over the study period (p&lt;0.00001). Prednisolone was most frequently prescribed (Figure 1). Females dispatched GCS prescriptions more often than males (55.8%). Males and females reached their peak prevalence between the ages of 60 and 70. Prescription rates of GCS were stable for all age groups except for the 90+ age group, where prescription rates increased significantly (p&lt;0.00001). Family medicine practitioners prescribed the highest amount of GCS, followed by physicians in specialist training, rheumatologists, oncologists, and internists (Table I). Of those who received prescriptions of GCS, 12.2% - 18.1% were classified as long-term users, representing 0.5% - 0.7% of the population. In the first years of the study there was an increase in the percentage of patients on long-term GCS therapy who received active bone protective therapy and the percentage remained stable around 22.5% until 2013. Since then, a declining number of patients have been receiving bone-protective therapy. Only 13.0% of chronic users received bone protective therapy in 2020. <h3>Conclusion</h3> Use of GCS has increased during the last two decades despite improvements in biological therapies for inflammatory disorders. The percentage of long-term users has remained stable. Meanwhile, the use of bone-protective therapy is declining. Thus, improvements in prophylaxis for corticosteroid-induced osteoporosis are urgently needed for patients who require long-term treatment with GCS. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Hulda Hrund Bjornsdottir: None declared, Olafur Einarsson: None declared, Gerdur Gröndal: None declared, Björn Gudbjornsson Speakers bureau: Novartis, Amgen, Nordic Pharma. Unrelated to this work, Consultant of: B. Gudbjornsson has received consulting fees from Novartis unrelated to this study.
POS0747 CORRELATIONS BETWEEN CAPILLARY DENSITY AND DEGREE OF SKIN PIGMENTATION IN HEALTHY CHILDREN ANALYSED BY NAILFOLD VIDEO CAPILLAROSCOPY
Authors: S. Bergkamp, V. Smith, T. Kuijpers, M. Cutolo, J. M. Van den Berg, D. Schonenberg-Meinema
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Nailfold Video Capillaroscopy (NVC) is a simple, non-invasive diagnostic tool but studies with normal values for capillary density in healthy children are rare. Ethnic background seems to play a role in capillary density; however, this is not well substantiated yet [1,2]. <h3>Objectives</h3> In this work, we set out to evaluate influence of ethnic background/skin pigmentation and age on capillary density reading in healthy children. Secondary aim was to investigate whether there is a significant difference in density between different fingers within the same patient. <h3>Methods</h3> Capillaroscopic images from healthy children were obtained in a one-time visit videocapillaroscopy (x200 magnification) addressing the capillary density (i.e. number of capillaries per linear millimeter in the distal row). This parameter was compared to age, sex, ethnicity, skin pigment grade (I-III) and between eight different fingers, excluding the thumbs. <h3>Results</h3> We investigated 145 healthy children with mean age of 11.03 years (SD 3.51). The range of capillary density was 4-11 capillaries per millimetre. We observed a lower capillary density in the 'grade II' (6.4 ± 0.5cap/mm, p&lt;0.001) and 'grade III' (5.9 ± 0.8 cap/mm, p&lt;0.0001) pigmented-classified groups compared to the 'grade I' group (7.0 ± 0.7 cap/mm). We did not find a significant correlation between age and density in the overall group. The fifth fingers on both sides had a significantly lower density compared to the other fingers. <h3>Conclusion</h3> Healthy children &lt;18 years with higher degree of skin pigmentation show a significantly lower nailfold capillary density. In subjects with an African/Afro-Caribbean and North-African/Middle-Eastern ethnicity, a significantly lower mean capillary density was observed compared to subjects with the Caucasian ethnicity (p&lt;0.0001, and p&lt;0.05, respectively. There were no significant differences between other ethnicities. No correlation was found between age and capillary density. The fifth fingers on both hands displayed lower capillary density compared to the other fingers. This needs to be taken into account when describing lower density in paediatric patients with connective tissue diseases. <h3>References</h3> [1]Andrade LE, Gabriel Júnior A, Assad RL, Ferrari AJ, Atra E. Panoramic nailfold capillaroscopy: a new reading method and normal range. Semin Arthritis Rheum. 1990;20(1):21-31. [2]Karbalaie A, Emrani Z, Fatemi A, Etehadtavakol M, Erlandsson BE. Practical issues in assessing nailfold capillaroscopic images: a summary. Clin Rheumatol. 2019. <h3>Acknowledgements</h3> We would like to thank all healthy children, their parents and the schools "Piet Hein", "de Knotwilg" and "Burgemeester Amersfoordtschool" for participating in our study, by undergoing a one-time capillaroscopy. <h3>Disclosure of Interests</h3> None Declared.
POS0217 ASSOCIATION BETWEEN VASCULAR FDG UPTAKE AND AORTIC DIMENSIONS IN GIANT CELL ARTERITIS: A PROSPECTIVE STUDY
Authors: L. Moreel, W. Coudyzer, L. Boeckxstaens, A. Betrains, G. Molenberghs, S. Vanderschueren, E. Claus, K. Van Laere, D. Blockmans
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Patients with giant cell arteritis (GCA) have an increased risk of developing aortic aneurysms. Retrospective studies have shown that <sup>18</sup>F-fluorodeoxyglucose (FDG) uptake in large vessels at diagnosis increases the risk of developing aortic complications during follow-up. <h3>Objectives</h3> To prospectively evaluate the association between vascular FDG uptake at diagnosis and the evolution of aortic diameter and volume in patients with GCA. <h3>Methods</h3> GCA patients who had FDG positron emission tomography (PET) imaging at diagnosis within 3 days of initiation of glucocorticoids and who were prospectively followed for at least 2 years were included. PET scans were visually scored (0-3) at 7 vascular areas and a total vascular score (TVS) was calculated, ranging from 0 to 21. Patients underwent a computed tomography (CT) scan at diagnosis and yearly thereafter for a maximum of 10 years. The association between vascular FDG uptake and aortic diameter and volume was estimated by linear mixed effect models with random intercept and slope adjusted for age, sex, cardiovascular risk factors, CT or PET/CT scan and intravenous contrast. The ascending aorta, aortic arch, and descending aorta were considered aneurysmatic when the diameter was ≥45, ≥40, and ≥35 mm, respectively. <h3>Results</h3> Hundred patients (mean age 70 years, 68% females) were included, of which 74 patients had FDG uptake ≥2 in any large vessel, 60 in the thoracic aorta and 49 in the abdominal aorta. Median follow-up was 80 months (IQR 47-110). The increase in ascending and descending aortic diameter and in thoracic aortic volume was higher in patients with vascular FDG uptake ≥2 compared to those without (<b>Table 1</b>). This increase was also significantly associated with TVS (<b>Figure 1</b>). FDG uptake was not associated with an increase in abdominal aortic diameter nor volume. Thoracic aortic aneurysms were more frequently observed in patients with thoracic aortic FDG uptake (27% versus 10%, aOR 6.6, 95%-CI 1.8-31.0, p=0.009) with a median time since diagnosis of 40 months (IQR 18-61). Two patients with high TVS (15 and 16) needed surgery for thoracic aortic aneurysm. <h3>Conclusion</h3> Thoracic aortic FDG uptake at diagnosis is an independent risk factor for developing thoracic aortic aneurysm in GCA patients. Higher TVS was associated with greater yearly increase in thoracic aortic volume and diameter. Follow-up of aortic dimensions may be necessary in these patients. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.